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 Information about the pricing system in German hospitals
( DRG-System)

Since January 1, 2004, a new pricing system for hospital services has been put in effect by German legislation. Based on similar systems elsewhere it is called DRG for Diagnosis-Related-Groups. Almost all the acute hospitals in Germany are obliged to use these - in principle fixed - prices for their invoices. We are providing examples from the 2007 catalogue on special website.

Contrary to the impression some hospitals like to convey to international patients, these official price regulations apply to all patients, including German and foreign private or self-paying patients. The relevant law (SGB 5) is absolutely unequivocal about that. This makes it possible to evaluate cost estimates and hospital bills on a legal basis.

The German DRGs divide hospital activities into more than 18 categories. Within these categories, which roughly relate to certain health areas (like eye diseases, respiratory organs, digestive organs), a specific DRG is defined according to the specific diagnosis, the medical procedures that were performed during the stay in hospital (surgical procedures, invasive diagnostic measures), the additional diagnoses and certain complicating aspects that were found. For each of the over 800 DRG codes a specific economic case value has been prescribed, and this case value, multiplied with a base rate which is up to now specific for each hospital produces the price that may be billed for a specific patient. The base rates, and thus the ensuing prices, are generally somewhat lower in smaller hospitals and in the southern regions of Germany. In the enclosed excerpts from the DRG catalogue, we have assumed an average base rate and calculated the according prices for about 150 DRG. Generally, the exact DRG can only be determined after the end of hospital treatment, but the amounts quoted in our list can be a good indicator. We can quote similar estimates for other treatments on request.

Most foreign patients, who cannot claim treatment on the basis of their social security health plan, will be considered private patients because they will be responsible for their bills personally. This means, that they will be offered to opt for being treated by the respective chairpersons of the clinical departments that are involved in the diagnostic and treatment scheme. In this case, these physicians will be entitled to individual payment for their individual services and these costs will be billed in addition to the hospital treatment costs based on DRGs. The amount of these physician’s fees is difficult to estimate beforehand as they are directly related to specific activities. The more treatment you need, the higher the bills will be. In our lists, we have simply added a certain percentage of the DRG-amount, but these additional fees can vary between 50% and 100% of the hospital costs

However, foreign patients are not obliged to contract this special personal treatment. If they opt for treatment by the medical staff of the hospital, they will also be treated by fully qualified senior residents but they avoid the additional physician bills. So here, for patients who do not care for special personal treatment by the chairman, there is a possibilty to substatially reduce the overall costs of treatment. Important to know: Hospitals are not permitted push patients into these private treatment agreements by refusing special accommodation or postponing treatment dates if patients decide to opt out of personal medical treatment.

The DRG-catalogue also includes average duration-of-stay figures for the respective procedure. These, also, only represent average estimates, but as such they can also be used to calculate another possible part of the costs of treatment: Most hospitals offer rooms with three beds as general standard. Patients who prefer the more comfortable single - or double-bed accommodation can choose this as supplement service. Per day, the costs will be another 50.-€ to 90.-€ approximately, depending on the standard and the hospital.

The cost estimate which follows from such factors, and which we offer in our DRG-Table is thus, this has to be underlined once more, not a fixed guaranteed price quote. Depending on the hospital we choose together with our customers, and depending on the standard of treatment and accommodation which is desired, there can be substantial differences. The figures are only given to give potential customers an idea what the pricing situation might look like.

DRG - Tables